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Establishing the Association Between Snus Use and Mental Health Problems: A Study of Norwegian College and University Students

Tjora, Tore, Skogen, Jens Christoffer, Sivertsen, Børge·2023·Nicotine & Tobacco Research
DOI 10.1093/ntr/ntac208PMC PMC9717367
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Abstract

Introduction: Smoking and mental health problems are public health concerns worldwide. Studies on smoke-free tobacco products, especially snus are scarce. Snus is considered less harmful than smoking and in the United States allowed to be marketed accordingly, but may still add to the burden of disease. Aims and Methods: Data stem from the Norwegian Students’ Health and Wellbeing Study (SHoT study) in 2018 (162 512 invited, 50 054 (30.8%) completed). Smoking, snus use, health service and medication usage and mental health problems, including the Hopkins Symptom Checklist-25 (HSCL-25), were assessed using self-report. The aims were to explore the associations between smoking and snus use and mental health problems and treatments. Furthermore, the association between both daily smoking and daily snus use and mental health problems. Associations were tested with χ2-, t-tests, and logistic regression. Results: Daily snus users had 38% increased odds (odds ratio [OR]: 1.38, CI: 1.30 to 1.46), and daily smokers had 96% increased odds (OR: 1.96, CI: 1.65 to 2.34) of having a high HSCL-25 score, adjusted for gender, low socioeconomic status (SES), using tobacco, participating in therapy and using antidepressants daily. Conclusions: Both daily smoking and daily snus use were associated with an increased level of mental health problems. The adjusted probability for mental health problems was lower for snus use; however, snus use prevalence was tenfold in our sample. Implications: Despite the lack of causal and directional conclusions, these associations may have implications for future legislation on snus. They also highlight the importance of more research, especially as snus is considered less harmful and seemingly replacing smoking in Norway.

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Sorted by citations

Authors
Tjora, T., Skogen, J. C., & Sivertsen, B.
Venue
Nicotine & Tobacco Research
Publisher
Oxford University Press (OUP)
Published
2022-08-29
Volume
25
Issue
1
Pages
135-142
ISSN
1469-994X
DOI
10.1093/ntr/ntac208
PMC
PMC9717367
Cited by
13
References
6
Language
en
Licence
creativecommons.org/licenses/by/4.0/ (vor)
Funders
  • Norwegian Ministry of Education and Research
  • Norwegian Ministry of Health and Care Services

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